Individual
JUSTIN GREGORY MERZLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
4511 ZEBE AVE, CHUBBUCK, ID 83202-4707
(208) 904-4780
(208) 904-4832
Mailing address
14926 W BRANDY LN, POCATELLO, ID 83202-5345
(208) 251-5027
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71322
ID
Other
Enumeration date
01/13/2022
Last updated
01/13/2022
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